Ventilator linked pneumonia

Bengaluru: Experts continue to be baffled by one of the ailments caused by a ‘critical care’ machine, namely Ventilator-Associated Pneumonia(VAP). This continues to be an area of concern, as critically ill patients often contract a life-threatening illness, by getting ventilator-associated pneumonia.

“Among hospital-acquired infections, pneumonia is considered to be the leading cause of death, mainly in patients being given mechanical ventilation in intensive care units (ICUs).

In the Western countries this issue has been taken up on a war footing,” explains Dr Ravindra Mehta, Apollo Hospital, Jayanagar, Bangalore. He adds that ten per cent of deaths in the ICUs happen because of VAP. Sadly, the country does not even have data regarding the deaths, unlike in America which reports 10 episodes per thousand ventilator days.

“The problem is with the interventional method used in a life-threatening situation. The very fact that you are putting a tube down the patient’s throat, you are disrupting the normal protective mechanism, as the pipe is being forced into the lungs. Many patients are unable to withstand even that. Hence, the immunity is compromised, which contributes to high mortality,” explains Dr Sudha Menon, Director, Internal medicines, Fortis Hospital.

One factor that can effectively reduce VAP deaths is oral health. “The oral hygiene status of patients is an important factor that has been linked to such deaths. Sadly, hospitals have the best infection control and still lives are compromised. Most hospitals have started oral health care but it is limited to just a disinfectant swab and cleaning of cheeks and lips,” explains Srivats Bharadwaj, founder of Vatsalya Centre for oral health.

He explains that during intubation the tube goes from the mouth and pushes the bacteria from the mouth into the lungs and the patient aspirates. Shockingly, half of the patients in the ICU get this condition within 48 hours of admission. “Research shows that the hospitals which implement the oral care protocol within the ICU reduce the incidence of VAP by 46% to 90%,” says Dr Srivats.